Successful Aging – How do you define it?

By Dr. Eric B. Larson - Spring, 2018

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As a doctor and health researcher, I’ve often heard experts try to define “successful” aging. They mostly focus on goals like avoiding illness and disability, holding on to your thinking and physical function, and maintaining an active social life. These are all great aspirations, but I sometimes wonder: Are such definitions really valuable? Do they help us plan for the future? Or do they lead to denial—making us think we can grow old without the changes that inevitably happen with age?

I remember a patient I cared for years ago, a retired circus worker with serious health conditions, including kidney damage. Knowing he would eventually need ongoing dialysis, he often told me, “Whatever happens, don’t put me on that kidney machine. I wouldn’t be able to stand it.” But to my surprise, when the time came, he changed his mind. Why? A new friend had come into his life, giving him a sense of purpose. What had once seemed an unacceptable way to live was no longer that at all. He had reset his priorities, allowing him to live happily for the remaining months of his life despite the bother of dialysis. He experienced a kind of “successful aging” he might have never before imagined.

Recognizing that people’s priorities often change over time, I worked with a University of Washington research team several years ago to determine what older people themselves value in aging. We surveyed two groups over age 65—some 700 Seattle-area Japanese-American elders and a general population of about 1,200 Kaiser Permanente members—to find out what matters most to them. Understanding how Japanese culture reveres aging, we expected to find differences in the two groups. But we were surprised to find the results were exactly the same.

Some of our findings may surprise you, too. For example, both groups rated “living a very long time” as least important. On average, they felt it was more important to keep learning, contributing, and being involved in others’ lives. They highly valued relationships. And most importantly, they wanted to stay in good health until close to death, living independently and not being a burden to their families.

These results may or may not align with your feelings about aging. But you may find it helpful to look at the items in the table and think about your own wishes and priorities. Which would you rank at the top of your list, in the middle, or at the bottom?

Such questions may give you a clearer sense of the changes ahead and how you’d like to prepare. Aging well is like planning for any important journey. If you can visualize the trip and predict what you’ll need in order to be safe and comfortable, you’re going to have a lot more joy along the way.

At the same time, it pays to stay flexible. In any journey—but especially a long one—the decisions you make at the beginning may not be the ones you’ll cling to later on. As a wise traveler, you may want to reassess your priorities as time goes by.

Dr. Eric B. Larson is vice president for health care research and innovation at Kaiser Permanente Washington and author of Enlightened Aging: Building Resilience for a Long, Active Life (Rowman & Littlefield, 2017).